Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study

Meriki, Henry Dilonga; Nji, Kah Emmanuel; Tufon, Kukwah Anthony; Tah, Yaoh Adolf; Atanga, Pascal Nji; Njunda, Anna Longdoh; Anyangwe, Irene Ane

doi:10.11648/j.ijhpebs.20190502.11

Cited by 2 publications

References 22 publications

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Determinant factors for the occurrence of tuberculosis after initiation of antiretroviral treatment among adult patients living with HIV at Dessie Referral Hospital, South Wollo, Northeast Ethiopia, 2020. A case-control study

et al. 2021

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Introduction Globally, tuberculosis takes the first rank for the ill-health of people living with HIV/AIDS. Despite the favorable outcome of antiretroviral therapy, the risk of tuberculosis remains higher among HIV patients. This obliges to identify factors for its occurrence and further prevention of drug-resistant tuberculosis. There is a contradiction between different studies and studies conducted in Ethiopia studied poorly the association between adherence to antiretroviral therapy and viral load with tuberculosis. Studies conducted in the study area were limited to cross-sectional study design. Therefore, this study claimed to identify factors determining the occurrence of tuberculosis after initiation of antiretroviral therapy. Methods This study was conducted at Dessie Referral Hospital by using a case-control study design on a sample of 565 with a control: case ratio of 3:1. Participants from controls were selected by systematic random sampling and from cases by consecutive random sampling. The data were collected by interviewing through structured questionnaires and from the medical record. The data were entered into Epi data version 3.1. In the multivariable analysis, variables with a P-value of ≤0.05 were anticipated as independent determinant factors. Result Patients without separate kitchen (AOR: 3.547, 95% CI: 2.137, 5.888), having opportunistic infection (AOR: 3.728, 95% CI: 2.058, 6.753), CD4 count of <350 cells/mm3 (AOR: 3.383, 95% CI: 1.520, 7.528), baseline WHO stage III (AOR: 3.321, 95% CI: 1.688, 6.534) or IV (AOR: 2.900, 95% CI: 1.251, 6.722), don’t taking IPT (AOR: 3.701, 95% CI: 2.228, 6.147) and those who were poorly adherent (AOR: 2.626, 95% CI: 1.272, 5.423) or moderately adherent (AOR: 3.455, 95% CI: 1.885, 6.335) to anti-retroviral therapy were more likely to develop tuberculosis after anti-retroviral therapy initiation. Conclusion Poor housing conditions, having an opportunistic infection, low CD4 count, starting ART at the advanced HIV stage, don’t take IPT, and being poorly adherent to antiretroviral therapy were associated with the occurrence of TB after initiation of ART. The institution should screen for TB as early as possible and strictly follow their drug adherence.

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Determinant factors for the occurrence of tuberculosis after initiation of antiretroviral treatment among adult patients living with HIV at Dessie Referral Hospital, South Wollo, Northeast Ethiopia, 2020. A case-control study

et al. 2021

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Predictors of advanced HIV disease in patients on antiretroviral therapy at the Buea Regional Hospital and co-infection rates of Mycobacterium spp. and Cryptococcus spp

Tcheumeni

Meriki

Sam

et al. 2022

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Background Human immunodeficiency Virus (HIV) and consequently the acquired immune deficiency syndrome (AIDS) remain a significant public health problem, having claimed 36.3 million lives so far. In 2020, approximately 680,000 people died from AIDS-related illnesses worldwide. Despite increased access to antiretroviral treatment (ART), the burden of mortality and morbidity due to advanced HIV disease (AHD) has not significantly changed over the years. AHD individuals are more prone to opportunistic infections– including Mycobacterium tuberculosis (MTB) and Cryptococcal meningitis (CM). CM has been reported as a significant cause of mortality among people living with HIV (PLHIV), accounting for 15% of the global AIDS-related deaths in 2019. To keep track of the global commitments made by governments to end the AIDS epidemic as a public health threat by 2030, knowledge of the burden of AHD and its risk factors are essential. Methods A hospital-based cross-sectional study was conducted from February 2020 to February 2021. HIV-infected individuals on ART at the Buea Regional Hospital were screened for AHD using World Health Organization (WHO) consolidated guidelines. A pre-tested semi-structured questionnaire was administered to the consented participants, and blood, sputum, and urine samples were collected. Acid fast bacilli microscopy detection and TB culture were carried out following standard microbiological procedures. Cryptococcus antigen lateral flow tests were performed using sera. Chi-square and regression analysis were carried out on SPSS at a p < 0.05 significance level. Results From a total of 3,229 PLHIV adults on care in the study period, 327 (10.1%) were suspected of having AHD, and were enrolled in the study. Most of the enrolled individuals were women (62.4%) and the mean age of the participants was 40.5 ± 24.7 years. A total of 130 (39.8%, [95% CI, 34.41–45.29]) participants presented with AHD and 41 (35.7%, [95% CI, 26.94–45.12]) and 7 (6.7%, [95% CI, 2.72–13.25) had TB and Cryptococcal infections, respectively. AHD was associated with male gender (aOR; 3.9, 95% CI; 1.40–11.70), and being on ART for more than 12 months was protective (aOR; 0.1, 95% CI; 0.01–0.35). Conclusion Even when ART uptake has dramatically improved in Cameroon, AHD (35.7%) is far beyond the UNAIDS reduction target of 10% by 2020 and thus, improvement in the management of PLHIV is warranted.

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Tuberculosis Incidence and Mortality Rates Among People Living with HIV Receiving Antiretroviral Therapy at the Buea Regional Hospital: A Seven Year Retrospective Study

Cited by 2 publications

References 22 publications

Determinant factors for the occurrence of tuberculosis after initiation of antiretroviral treatment among adult patients living with HIV at Dessie Referral Hospital, South Wollo, Northeast Ethiopia, 2020. A case-control study

Determinant factors for the occurrence of tuberculosis after initiation of antiretroviral treatment among adult patients living with HIV at Dessie Referral Hospital, South Wollo, Northeast Ethiopia, 2020. A case-control study

Predictors of advanced HIV disease in patients on antiretroviral therapy at the Buea Regional Hospital and co-infection rates of Mycobacterium spp. and Cryptococcus spp

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